After the shooting at Sandy Hook Elementary School, some policymakers have called for considering outpatient commitment laws that allow for court-ordered treatment of people with mental illness who could be dangerous to themselves or others.
Forty-four other states have such laws, but the concept has been unpopular in Connecticut, where the mental health system’s focus is aimed at engaging people in treatment and giving them choices.
In an article by Arielle Levin Becker in The Mirror last week, Patricia Rehmer, commissioner of the Department of Mental Health and Addiction Services, expressed her opposition to outpatient commitment, also known as assisted outpatient treatment.
Rehmer said requiring people to get treatment could alienate them from the system that could help them, and said that no one would consider requiring people with diabetes to take their medication.
It can be awful for relatives to watch a family member deteriorate, Rehmer said, but said it’s also important to protect the civil rights of people with mental illness.
Here is a response from Jeanne Mirisola, whose son has a serious mental illness.
To Patricia Rehmer:
I am the parent of a 31-year-old son suffering from a serious and persistent mental illness who has been hospitalized 27 times in eight years.
I am stunned every time I read about people in a position to help our seriously mentally ill (SMI) by changing legislation to facilitate getting them the help they need who don’t act because of the mistaken belief that we are infringing upon their civil rights.
This is NOT a civil rights issue, it’s a medical issue.
Commissioner Rehmer, if your Mother were wandering the streets on a cold winter’s night, lost because she was suffering from Alzheimer’s, would you just leave her there because it would be a violation of her civil rights to get her into treatment? I think not!
My son, like up to 50 percent of those suffering from an SMI, lacks the capacity to know he is sick. I have had mental health professionals here in Maine, where I live, tell me that my son’s right to be psychotic supersedes his right to treatment. So, I am supposed to believe that the fact that he doesn’t know he is sick doesn’t matter?
I’m supposed to believe that it’s acceptable to let him wander the streets barefoot in the snow which, by the way, has happened many times here in Maine.
Only once, did the powers that be whom I had contacted each and every time this happened, see this as a reason to get him help, albeit against his will, because he could not recognize that he was ill.
Commissioner Rehmer, you said, “… that there are ways to get people who don’t think they’re ill to get treatment, often through the urging of someone they have a strong relationship with. Requiring treatment would undermine those relationships and turn people away from the system.”
I have had similar statements made to me while watching my son suffer. Things like, “over the course of several years, perhaps we can build a trusting relationship and he will accept treatment,” or, once when he was so psychotic that he stopped buying food in the group home he was living in, the team worker said, “If we let him get a little hungry, he will accept treatment.”
Really? Guess what. It didn’t work.
You are also sadly mistaken if you think that having Assisted Outpatient Treatment (AOT) laws that work and the ability to get someone hospitalized when they are gravely ill would somehow undermine the relationship they have with those who love and care for them every day and suffer right along with them.
If you are referring to the mental health professionals working with them, why can’t you see that their hands are tied to help them at all until they can get the medication they need to bring them back from their psychosis and, without effective AOT laws and people actually using those laws (to date, for the most part, they don’t apply here in Maine, with the exception of a small group of patients out of the state hospitals).
Not having an effective way to get help for our loved ones is exactly what does, in fact, undermine our relationship with them. Because they don’t know they are sick, and we are trying to get them help, they see us as the bad guys.
In fact, what I have learned over the years is that, of the 1 percent of these folks who become violent, they most often kill their caregiver, the one who is trying to get them help.
Jeanne Mirisola
Cape Neddick, Maine
Related: After Newtown: A rethinking of Connecticut law on outpatient commitment